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3045 Impact of the COVID-19 Epidemic on Patients with Myeloproliferative Neoplasia: The French Prospective Observational Study Covim

Program: Oral and Poster Abstracts
Session: 634. Myeloproliferative Syndromes: Clinical and Epidemiological: Poster II
Hematology Disease Topics & Pathways:
MPN, Chronic Myeloid Malignancies, Diseases, Myeloid Malignancies
Sunday, December 11, 2022, 6:00 PM-8:00 PM

Laurence Legros, PhD, MD1,2*, Françoise Boyer perrard3*, Dana Ranta, MD4*, Lydia Roy, MD5,6*, Mario Ojeda-Uribe7*, Stephane Giraudier, MD, PhD8,9*, Nathalie Parquet, MD10*, Jean Christophe Ianotto, MD, PhD11*, Mathieu Wemeau, MD12,13*, Isabelle Plantier, MD14*, Franck E. Nicolini, MD, PhD15, Eric Lippert, MD, PhD13*, Pascale Cony-Makhoul, MD16*, Fiorenza Barraco, MD17*, Laure Stalnikiewicz18*, Frederic Garban19*, Brigitte Dupriez, MD, PhD13, Francois Girodon, MD, PhD 13, Anne Brignier, MD10*, Yazid Arkam, MD20*, Mathieu Meunier21*, Chloe James, MD, PhD13,22*, Valérie Rolland-Neyret23*, Valerie Ugo, MD, PhD13,24, Pierre Morel, MD25*, Marie C Bene, PharmD, DPhil26* and Jean-Jacques Kiladjian, MD27,28

1France Intergroupe des Néoplasies Myéloprolifératives, FIM collaborative group, Paris, France
2Department of clinical Hematology, APHP-Université Paris Saclay-Hôpital Bicêtre, Kremlin-Bicêtre, France
3Service des maladies du sang, Centre Hospitalier Universitaire d’Angers, Angers, France
4Centre Hospitalier Universitaire, Nancy, France
5Hematology department, Hopital Henri Mondor, Creteil, France
6FIM, paris, France
7Department of Hematology and Cellular Therapy, GHRMSA, Mulhouse, France
8INSERM UMR 1131, Saint-Louis Research Institute, Paris, France
9Université de Paris, Cellular biology Department, Saint-Louis hospital, APHP, Paris, France
10Therapeutic Apheresis Unit, Saint Louis Hospital, Paris, France
11Department of Hematology, CHU de Brest, Brest, FRA
12CHR de Roubaix, Roubaix, FRA
13France Intergroupe des Néoplasies Myéloprolifratives, FIM collaborative group, Paris, France
14Service d'hématologie clinique, CH Roubaix, Roubaix, France
15Hematology department & CRCL1052, Centre Léon Bérard, Lyon, France
16Service d'Hématologie, Centre Hospitalier Annecy-Genevois, Pringy, France
17Department of Hematology, Centre Hospitalier Lyon Sud, Pierre Bénite, France
18Centre hospitalier Lens, lens, French Southern Territories
19Department of Hematology, CHU Grenoble Alpes, Grenoble, France
20Service d'hématologie, GHR Mulhouse Sud Alsace, mulhouse, France
21Department of Hematology, CHU de Grenoble, La Tronche, FRA
22Unite INSERM U1034, Pessac, FRA
23CHU de Grenoble, Grenoble, France
24Hematology Biology, Angers University Hospital, Angers, France
25Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Amiens, Salouel, France
26Hematology Biology, Nantes University Hospital, Nantes, France
27French Intergroup of Myeloproliferative neoplasms, FIM collaborative group, Paris, France
28Centre d’Investigations Cliniques, Hôpital Saint-Louis, Paris, France

Methods. The aim of the observational COVIM study was to assess the rate of severe COVID-19 infection in subgroups of French patients with MPN during the pandemic. To this avail, it included all consecutive patients from 21 French centers seen in consultation or teleconsultation between May 12, 2020, and may 31, 2021. Information was collected about MPN characteristics and treatment as well as the occurrence, management and outcome of COVID-19 infection and follow-up. The study has been registered on ClinicalTrial.gov (NCT 04416438).

Results. A total of 1793 consecutive patients (47% males) was included. The median age at inclusion was 67 yo (IQR 56-75). MPN subtypes were 37% PV, 45% ET and 18% MF. MPN driver mutations were 78% JAK2V617F, 14% CALR and 3% MPL while 5% of the patients had no driver mutation detected. The most frequent MPN treatments were hydroxyurea (HU) or pipobroman (51%), interferon (IFN) (19%), ruxolitinib (12%) and anagrelide (3%) alone or in combination; 15% of the patients did not receive cytoreductive therapy. The majority of patients (80%) received antiplatelet therapy as thrombosis prevention.

A total of 295 episodes of COVID-19 infection were identified in 287 patients, documented in 196 cases by SARS-Cov-2 PCR and/or serology and by clinical history or CT scan for the remaining cases. Seven episodes were asymptomatic, 6 associated with thrombosis (4 pulmonary embolisms, 1 splanchnic, 1 stroke) and 27 with acute respiratory failure. Hospitalization was required for 63 patients (only conventional n= 38, intensive care unit n=25). Cytoreductive treatment was maintained in 88% of the cases, discontinued in 12% and decreased in 1 patient respectively. At last follow-up, 20 patients with COVID-19 had died, as a consequence of the infection for 15 and of MPN (acute transformation) in 3 (2 unknown causes). This yields a global COVID-19 related death rate of 5,2% in these 287 patients. Comparison between the MPN population with and without a COVID infection showed that older age and arterial hypertension were significant risk factors. In contrast, treatment with IFN was associated with less severe forms of COVID-19, the median age of these patients being however younger.

Conclusions. This large observational and prospective cohort of patients with MPN demonstrated a rate of COVID-19 infection of 16%. Among patients with COVID-19, 22% required hospitalization. These rates indicate that the pandemic did not so dramatically affect this specific population of patients, with an overall COVID-related mortality 0.8%. Two hypotheses could be raised for this low rate of infection. One is that MPNs do not constitute an additional risk factor for SARS-CoV-2 infection. On the other hand, patients with MPN may have applied very strictly preventive measures as they were informed of a potentially higher risk in patients with hematological malignancies.

Disclosures: Legros: Novartis: Honoraria; Pfizer: Honoraria, Other: travel accomodation; Incyte: Honoraria; celgene/BMS: Honoraria; Amgen: Honoraria. Boyer perrard: Novartis: Honoraria. Ranta: Janssen: Membership on an entity's Board of Directors or advisory committees. Nicolini: Incyte biosciences: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Novartis Services, Inc.: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Sun Pharma Ltd: Consultancy; KARTOS: Consultancy; Pfizer: Membership on an entity's Board of Directors or advisory committees. Cony-Makhoul: Pfizer, Novartis Pharma, Incyte: Consultancy, Other: Support for travels; Research grants to CH Annecy Genevois for observational and clinical studies, Speakers Bureau. Brignier: OCTAPHARMA: Research Funding; SANOFI,: Research Funding; GILEAD-KITE: Research Funding; AMGEN: Research Funding; THERAKOS: Research Funding; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees; JANSSEN: Honoraria, Membership on an entity's Board of Directors or advisory committees. James: Novartis: Other: travel accomodation, Research Funding. Kiladjian: BMS: Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees; AbbVie: Membership on an entity's Board of Directors or advisory committees.

*signifies non-member of ASH